How can we prevent medication errors at homecare? - A guide
A medication error is simply an error made when providing or taking medicine. Generally, medication error occurs if the incorrect medication is taken, an incorrect dose is given, or medication is not provided at the correct time. So, nurses must be careful while managing medications in care homes.
Throughout this article, we will provide insights into what is a medication error, what are causes of medication errors in the homecare sector, and how to prevent medication errors in care homes in the UK.
What is a medication error?
A medication error is a mistake that happens at any point in the medication process, from prescription to delivery, and which can lead to improper medicine usage or patient harm. Miscommunication between homecare providers, patients, and caregivers can lead to medication errors. Medication errors can cause serious issues for patients such as worsened health conditions, hospitalization, or even death. Some examples of medication error include providing the incorrect drug to the patient, which is not prescribed for their condition, giving a drug with an incorrect dosage, missing the dosage of medication in the scheduled time, fault in effectively tracking the patient's reaction to the medicine, storing the medicine in an improper place such as a place with severe temperatures.
What are the types of medication errors in care homes?
The following are some of the types of medication errors in care homes in the UK, the root causes of the error, and their consequences.
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Wrong medication:
This mistake happens in the care home when a caregiver gives a drug to the patient which differs from one prescribed for the patient. The main causes leading to wrong medication errors are misreading labels, confusion due to the similar name of the drug, and packaging errors from the pharmacy. The consequence of providing the wrong medicine is large, ranging from ineffective treatment to harmful effects.
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Incorrect dosage:
This error occurs when the caregiver provides a medication different from one prescribed by the doctor. Sometimes the caregiver provides too much medication to the patient. This mistake is generally known as a "double medication error". This overdose leads to harmful side effects. Providing a dosage less than prescribed will result in ineffective symptom relief.
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Wrong route of administration:
When caregivers provide drugs in the wrong method, such as medication meant to be taken orally through injection and topical medications orally. These mistakes lead to very harmful effects to patients such as gastrointestinal issues and metabolization problems.
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Improper timing:
When caregivers provide medication to patients either too early or too late according to the prescribed schedule will affect the patient's health and the outcome of the treatment. The main cause of this type of error is lack of communication and incorrect understanding of medication.
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Expired medications:
This type of error occurs when caregivers provide the drug to a patient with its expiry date is over. Expired medication leads to a decrease in the usefulness and effectiveness of the drug provided.
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Medication storage problems:
When drugs are not stored properly according to the guidelines it leads to decaying of the drug and it becomes ineffective. Most medications need a specific temperature for their storage, deviation from this range of temperature makes the drug ineffective for the treatments.
What are the main causes of medication errors in care homes?
To implement effective prevention strategies for medication errors and to ensure high-quality care, understanding the causes of the errors is very important. The causes are different for each type of medication error. The following are the main causes of medication errors in care homes in the UK,
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Communication breakdown:
Poor communication between healthcare providers, caregivers, and patients results in misunderstandings about the dosage of drugs and the correct schedule for providing drugs. This may cause wrong medication errors, incorrect dosage, and improper timing errors.
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Inadequate staff training:
A highly skilled and knowledgeable caregiver is required in care homes due to the complexity of the treatment plans and the diversity of the drugs provided. When caregivers lack adequate training, they could find it difficult to understand the complexities of drug management.
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Look-Alike and Sound-Alike medications:
When two or more medications have names or packaging are identical there is a chance to select the wrong drug or dosage. The consequences of this are very harmful to the patient or even life-threatening situations.
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Insufficient technology utilization:
In manual record-keeping methods, medication mistakes might occur as a result of human mistakes, such as unreadable writings and misplaced documentation. We can reduce these mistakes by efficient use of technologies such as electronic health record systems (EHR), Electronic medication administration records(eMARs), and Medication dispensing devices in the homecare sector of the UK. Insufficient technology utilization is the main cause of medication errors in care homes.
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Documentation errors:
Accurate documentation is very important to understand which drugs were given, when, and in what amounts. If the documentation is incorrect, incomplete, or has errors patients may receive the wrong drug or incorrect dosage.
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High workload and fatigue:
High workload and fatigue of the caregivers lead to medication errors in homecare. Due to the workload caregivers provide the wrong route of administration and due to lack of time for double-checks and verification of the medication orders.
How can prevent medication errors in homecare settings in the UK?
For the effectiveness of the treatments and quality of care reduction and prevention of medical errors are important. The following are the key strategies to reduce medication errors and improve patient safety in the homecare sector in the UK.
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Medication reconciliation:
It is the process of creating and maintaining an accurate, thorough, and up-to-date record of a patient's medication including the prescription of the drugs. This record involves the medication's name, purpose, dosage, and the date it was last provided. Regular reviews are essential to prevent medication errors and it is a part of medication reconciliation.
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Application of 5 Rights of Medication Administration:
It involves five essential principles that serve as a safety measure against medication errors in homecare in the UK. Five principles are,
Right patient: Before providing medication, it is important to confirm the identity of the patient by their full name and date of birth. It helps to identify providing drugs to the right patient.
Right medication: It is important to double-check the details of the drug provided, such as the name of the drug, and dosage according to prescription.
The right dose: Before providing the drug to the patient, it is important to ensure the correct dosage is provided or not to prevent ineffective treatment.
Right route: The procedure for providing drugs is different, such as oral and topical. So important to identify the correct route for providing a drug.
Right time: Caregivers should follow the prescribed schedule for providing medication to prevent complications in the health conditions of the patient.
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Double-check protocols:
This protocol in the UK helps to identify medication errors before reaching the patient. This process involves a continuous review of medication administration procedures such as the name of the medication, dosage, and patient information.
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Medication alerts:
Computerized physician order entry (CPOE) systems with medication alerts are very helpful for identifying and preventing medication errors in-home care. These systems can alert at the time if any error occurs such as the wrong drug or wrong dose.
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Proper storage of medication:
Medications need a specific temperature, humidity, or light to avoid their degradation. So, storing such medication in the correct temperature and humidity is essential, and the refrigerated drugs should be kept in the proper area for correct refrigeration. Storage of drugs with the same name in different places is also important to prevent mix-ups of the drugs.
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Proper documentation of the procedures:
The documentation of the medication administration is essential to reduce medication errors. It helps to identify the correct dosage and right drug and the right time for administration.
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Establishment of medication error policy:
This is an important component of homecare for the patient's safety. This medication error policy involves identifying, reporting, and preventing medication errors to avoid harm to the patients. According to the medication error policy, immediate action should be taken to investigate the root cause of the error and remedy to prevent the mistakes.
So, Identification and prevention of medication errors are very important in the homecare sector in the UK to improve the quality of care and to make the patient healthy and safe in the home. Nurses Group Homecare in the UK is filled with skilled caregivers, and we provide a homecare environment with good quality of care.